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Objectives: The use of radical prostatectomy is increasing with the rising incidence of prostate cancer. We assessed the surgical trends related to radical prostatectomy using data from a multi‐center, retrospective cohort study, the MICAN (Medical Investigation Cancer Network) study, which was conducted in all the urology‐related medical facilities in Ehime Prefecture, Japan. Methods: We compared data from the MICAN study with prostate biopsy registry data collected in Ehime between 2010 and 2020 and recorded the surgical trends. Results: There was a significant increase in the mean age of patients with positive biopsies, and the positivity rate increased from 46.3% in 2010 to 60.5% in 2020, while the number of biopsies obtained decreased. The number of radical prostatectomies performed increased over the years, with robot‐assisted radical prostatectomy becoming the predominant procedure. In 2020, robot‐assisted radical prostatectomies accounted for 96.0% of the surgeries performed. The age at surgery also gradually increased. Of the registered patients aged ≤75 years, 40.5% underwent surgery in 2010, compared with 83.1% in 2020. The prevalence of surgery also increased from 4.6% to 29.8% in patients aged >75 years. There was a gradual increase in the proportion of high‐risk cases, from 29.3% to 44.0%, but a decrease in that of low‐risk cases, from 23.8% in 2010 to 11.4% in 2020. Conclusions: We have shown that the number of radical prostatectomies performed in Ehime is increasing in patients aged both ≤75 and >75 years. The proportion of low‐risk cases has decreased, while that of high‐risk cases has increased. [ABSTRACT FROM AUTHOR]